| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $323.70 | $323.70 | $323.70 | |
Aetna
| Professional | $211.19 | $262.73 | $323.70 | |
CareSource
| Facility | $45.06 | $56.02 | $74.34 | |
CareSource
| Professional | $32.68 | $56.02 | $108.22 | |
Cigna
| Facility | $318.39 | $318.39 | $318.39 | |
Cigna
| Professional | $270.64 | $270.64 | $318.39 | |
United
| Professional | $23.17 | $30.98 | $74.78 |